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Muscle strains are way of life for all athletes

4/6/13: John Lackey suffers a right biceps strain delivering a pitch in the fifth inning of his return start and is forced to exit the game

By Gary Gillis
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Special to MLB.com |

Do you remember being a kid and having somebody tell you: "You can be anything that you want to be if you try hard enough."

Really? I labored through two solid months of guitar lessons and not once did anybody mistake me for Jimi Hendrix. That's when I set my sights on becoming a professional athlete. And while I never enjoyed the pleasure of pulling in a paycheck on the playing field, I was much more successful in feeling the pain. Just like a pro.

"Our bodies are designed for physical exertion," said Kathy Shillue, a physical therapist at Beth Israel Deaconess Medical Center. "But they are not always prepared for a particular level of exertion or an unfamiliar motion. Those situations often lead to muscle strain."

Muscle strains are a sort of equal opportunity injury. Whether you are a couch potato, a weekend warrior or even in peak physical form, nobody is immune. No body. Peruse Major League Baseball's injury report and you will find that almost every team has at least one player dealing with a muscle issue.

Red Sox pitcher John Lackey just returned to the rotation after being sidelined for three weeks with a right biceps strain, while Joel Hanrahan pulled up with a bad hamstring two weeks ago and also recently came off the disabled list.

"While they can vary a great deal in terms of severity, a hamstring strain that occurs at Fenway Park is pretty similar to a strain that happens at a company softball game. But it's probably more likely to occur in the softball game," Shillue explained. "Professional athletes are in better shape than the average adult. Their muscles are generally stronger and, given their training regimens, more flexible."

In the offseason and through Spring Training, starting pitchers build up their strength to the point where they can go out and throw 100 pitches a game. They are expected to do that every five days. If you picked up a ball and tried that (even if you rested every 12-15 pitches), your arm would ache from shoulder to fingertip.

"Repetitive use of a muscle, even if it isn't high-intensity exercise, can lead to injury. And even if you are in very good shape the introduction of a new or unfamiliar activity can lead to problems," Shillue said. "For example, a novice golfer will be more prone to injury when first playing even if he is strong, fit and flexible compared to an expert player, because the novice hasn't yet developed control of the whole pattern of movements. So a person's form is also important."

Lackey's injury occurred in the fifth inning of a game on April 6, but it didn't appear to be an issue of stamina. Indeed, after missing all of last season recovering from Tommy John surgery, the immediate concern was that it was an elbow injury, but it quickly became clear it was a muscle issue. What's less clear is exactly why it happened.

"Sometimes the cause of a strain is clear," Shillue said. "Maybe it happens when you're running to catch a bus. Or it could be something you've done hundreds of times like reaching to pick up a bag of groceries, and this time you feel a twinge in your back."

The treatment of a muscle strain depends upon the severity. Mild strains may require nothing more than rest and a non-steroidal anti-inflammatory such as aspirin or ibuprofen. A more severe strain might benefit from the RICE approach -- rest, ice (20 minutes an hour), compression (an Ace bandage or other elastic wrap) and elevation.

Prevention isn't a bad idea either.

"If your body is used to exertion there is less chance of injury," Shillue said. "Consistency in exercise is important for general flexibility and building strength, and that protects you in some respects from injury. But sport-specific training to develop motor skill is also important -- especially in the overuse-type strains."

Of course, you'll want to start slow and build up your capacity for exercise. And if you start now, you just may be the star of the company outing, racing to make that game-saving catch. Just like the pros.

Gary Gillis is a contributor to MLB.com. The BID Injury Report is a regular column on redsox.com. Beth Israel Deaconess Medical Center is the official hospital of The Boston Red Sox. This story was not subject to the approval of Major League Baseball or its clubs.